Reduce Heavy Menstrual Cramps

Over 75% of women suffer from menstrual cramps (or dysmenorrhea), and at least 10% of women suffer from severe menstrual cramps. Severe menstrual cramping can drastically affect a woman's quality of life for several days each cycle. If every month brings you a lot of aches, pains, and discomfort, you can relieve your symptoms medically or through lifestyle changes. Your period may never be fun, but you can at least eliminate some of its worst symptoms.

Steps

Seeking Medical Treatment to Relieve Severe Cramps

1. Determine what kind of cramping you are experiencing. There are two types of cramping: primary dysmenorrhea and secondary dysmenorrhea. Primary dysmenorrhea is more common and less serious than secondary dysmenorrhea, though both kinds of cramping can cause severe pain. You can talk to your doctor about pain relief for both kinds of cramping, but if you think you are experiencing secondary dysmenorrhea you will require medical treatment and should talk to your doctor as soon as possible.
   • Primary dysmenorrhea is more common and is caused simply by the hormones and hormone-like substances released during a menstrual cycle. Prostaglandins help the uterus shed its lining, but can also be overproduced by the body. When overproduced, prostaglandins can restrict blood flow to the uterus, causing pain. Primary dysmenorrhea can be experienced by any menstruating woman or girl, and usually starts a few days before a period begins and subsides when the period is over.
   • Secondary dysmenorrhea, however, is caused by another underlying health issue, such as endometriosis, pelvic inflammatory disease, a sexually transmitted infection, problems with an intrauterine device (or IUD), or fibroids. Secondary dysmenorrhea is more serious, and usually affects women who have been menstruating for several years. Secondary dysmenorrhea can also cause pain even when a woman is not experiencing pre-menstrual syndrome or menstruation.
   • If your cramps are due to endometriosis or fibroids, surgery might be necessary to eliminate your pain. If your cramps are due to pelvic inflammatory disease, you might need prescription antibiotics.
2. Seek immediate medical attention if you experience worrying symptoms. If in addition to your cramps you experience other symptoms, you will have to talk to a doctor right away. These might be signals of something more serious than regular cramping:
   • A change in your vaginal discharge
   • Fever
   • Sudden and sharp pains when your period is late
   • You had an IUD inserted over several months ago and are still cramping
   • You think you might be pregnant
   • Your pain doesn't go away when your period is finished
   • You should also talk to your doctor if you aren't experiencing any pain relief after making recommended changes. Your doctor might want to perform an ultrasound or laparoscopy exam to make sure you don't have cysts, infection, or other chronic health problem.
3. Ask your doctor for a prescription for birth control. Hormonal birth control of any kind (patch, ring, pill, shot) can reduce symptoms. Low-dose birth control helps reduce the production of prostaglandins, which reduces menstrual cramping. Birth control is one of the most common and recommended methods of reducing cramping medically.
   • Hormonal birth control can cause side effects, such as deep vein thrombosis, acne, breast tenderness, and increased blood pressure. Birth control pills are, however, much safer now than birth control pills of the past, and many of the risks are very slight. Discuss any potential risks with your doctor.
   • Even if you stop taking birth control pills after 6-12 months of use, you might still experience pain relief. Many women report a reduction in cramps even after discontinuing use of hormonal birth control.
   • Intrauterine devices (IUDs) that contain hormones, such as Mirena, can also help treat severe cramping.
   • Some hormonal forms of birth control also reduce the frequency of periods, so that women might only have 4 periods instead of 12 per year, and others may not experience periods at all. These types are known as continuous birth control pills, and many doctors assure that they are just as safe as other forms of hormonal birth control. Reducing the frequency of menstruation could reduce the frequency of painful cramping.
4. Ask your doctor for a prescription pain reliever if over-the-counter medications are not working. While it is generally recommended that you try over-the-counter pain relievers first, it is possible that they will not be effective for you. Discuss the possibility of trying a prescription painkiller, such as mefenamic acid, with your doctor.

Using Over-the-Counter Medicines to Relieve Pain

1. Ask your doctor if you can safely use NSAIDS (non-steroidal anti-inflammatory drugs). Over-the-counter Non-steroidal Anti-inflammatory Drugs (or NSAIDS) can be very effective at relieving cramps. NSAIDS are not only analgesics (painkillers) but also anti-inflammatories, which means they help to stimulate blood flow to the uterus, thereby reducing cramping. They may also help reduce the amount of menstrual flow. Common NSAIDS include Ibuprofen and Naproxen.
   • Not everyone can safely use NSAIDS, however. People who are younger than 16, or who suffer from asthma, liver, or kidney problems should not take NSAIDS. Consult your physician before beginning any painkiller regimen.
   • NSAIDS are the most effective for cramps, but you can take alternative painkillers if you are not permitted to use NSAIDS. For example, painkillers such as acetaminophen might be helpful.
2. Take NSAIDS as directed during your symptoms. In order for the NSAIDS to work effectively, you cannot delay taking them. Begin taking NSAIDS when you first detect your symptoms, and continue taking them as directed for 2-3 days or until symptoms subside. Be sure to follow all package instructions, however.
   • Consider keeping a menstrual diary so that you know when you can begin to experience symptoms each month.
   • Be sure that you are not taking too many NSAIDS. Follow all instructions on the medication and from your doctor. NSAIDS do have some side effects, especially with long-term use, so be careful not to overdo your painkillers each month.
3. Take vitamin supplements to reduce cramping. While vitamins do not relieve pain if you are currently experiencing severe menstrual cramping, Vitamin D supplements might be able to prevent menstrual cramps from occurring in the first place. Other supplements that might help reduce cramping are Omega-3 fatty acids, Magnesium, Vitamin E, Vitamin B-1 and B-6.
   • You should consult your physician before beginning a vitamin regimen to ensure that you will not experience any adverse effects. Always follow package instructions carefully when taking over-the-counter medicines and supplements.
4. Talk to your doctor about prescription medications. If your cramping is severe, talk to your doctor about prescription options to help you manage the pain. There are a few options that your doctor may recommend:
   • Hydrocodone and acetaminophen (Vicodin, Lortab) may be recommended for moderate to severe pain caused by cramping.
   • Tranexamic acid (Lysteda) can help if your cramps are caused by excessive bleeding. You take this medication only during menstruation to reduce flow and cramping.

Using Physical Activity to Reduce Cramping

1. Exercise gently when you experience cramping. While you should not engage in high-impact, strenuous exercise regimens during severe menstrual cramps, gentle exercise can relieve symptoms by stimulating blood flow and releasing endorphins.
   • Effective exercises during cramping are aerobic exercises such as walking, biking, or swimming.
   • Yoga poses that stretch the back, groin, chest, and abdominal muscles might also help stimulate blood flow to the uterus and relieve pain.
   • Make sure that you are exercising gently, while wearing loose and non-restrictive clothing. Overdoing it or wearing constrictive clothing might aggravate symptoms.
   • An added benefit of exercise is potential weight loss, which can also reduce the frequency of menstrual cramps.
2. Have an orgasm. While it might seem counterintuitive to engage in sexual activity during menstrual cramping, sexual activity can be a great way to relieve symptoms. Orgasms help to relieve cramping by stimulating blood flow, releasing endorphins, and killing pain. Plus they might serve as a welcome distraction from your pain.
3. Massage your abdomen. Rubbing the affected area can help stimulate blood flow to the uterus, which can ameliorate that cramping feeling. Massage your lower belly gently with your fingertips and use a circular motion. You can massage your abdomen for as long as you need to, as often as you need to, in order to reduce your symptoms.
   • Acupuncture and acupressure might have positive effects similar to massage. Some women have reported pain relief through these services. Acupuncture and acupressure work by stimulating the central nervous system in order to heal injuries and relieve pain. If you take this route, be sure that you talk to your doctor first and that you do your research: you only want to see a licensed professional, not an amateur.
4. Take a hot shower or bath. Heat helps to increase blood flow, which helps minimize cramping pains. Run yourself a hot bath whenever you feel the worst cramps coming on. Repeat once or twice a day as needed.
   • If you cannot take a hot bath, you can get similar benefits by applying a hot water bottle or heating pad to your abdomen for 20 minutes at a time.
   • Be sure that you are not overdoing the heat: you do not want to scald or burn yourself. A comfortable warmth is just as effective and much safer than a scalding heat.
   • Heat can be equally as effective as pain medication for reducing menstrual cramps, and has fewer side effects.

Changing Your Diet to Relieve Menstrual Cramping

1. Avoid caffeine, alcohol, and salty foods in the days prior to your period. Because cramps are often caused by the constriction of blood vessels, you do not want to consume any product that restricts your blood flow, such as diuretics or sodium-rich foods. Stay away from caffeine, alcohol, and junk food during your period to help minimize cramping. Adjust your diet several days before you expect your period to begin, and keep your diet adjusted for the duration of your period.
   • You should also avoid cigarettes during your period if you want to avoid cramping for the same reason: you don't want to constrict your blood vessels any further.
2. Drink plenty of water. Staying hydrated will help keep your blood vessels from constricting. It is especially important to stay hydrated if you are engaging in other physical activities to help reduce cramping, such as taking hot baths or exercising.
3. Drink chamomile tea. Chamomile can help reduce inflammation, which will relieve your cramping symptoms. Chamomile tea can also help replace your desire for caffeinated beverages such as coffee and black tea, which are things to avoid during menstrual cramping.
4. Eat light meals more frequently. Instead of three heavy meals each day, try eating more, lighter meals.
5. Eat calcium-rich foods. Calcium-rich foods might also help relieve symptoms. Foods rich in calcium, include dark, leafy greens like kale or spinach, tofu, almonds, soy, sardines, and low-fat dairy, and are part of a generally healthy diet.

Tips

• Consider combining several of the methods above in order to combat menstrual cramps. For example, exercising gently while taking an NSAID might be more effective than either method by itself.
• Make sure that menstrual cramps are not interfering with daily life or school. Adolescent girls are particularly susceptible to severe menstrual cramps, and it is one of the leading causes of missed school. And many adult women miss work due to severe menstrual cramps. Talk to your doctor if your menstrual symptoms are disrupting your everyday activities.
• Keep a menstrual diary to keep track of any symptoms or pain you experience during your cycle as well as its duration. This can help you prepare for the onset of symptoms and make any necessary adjustments, such as reducing your caffeine intake and increasing your calcium intake. A menstrual diary will also allow you to know if you are experiencing any strange or sudden changes to your cycle that you should discuss with your doctor.

Warnings

• Talk to a physician before taking any over-the-counter medicines or supplements to make sure they are safe. Ask about side effects of any other-the-counter substances. Make sure you use any medications as directed, and do not exceed dosage recommendations.
• Go to a doctor immediately if your cramps last beyond your menstrual cycle, if you are experiencing abnormal bleeding, nausea or vomiting, or if it is possible that you are pregnant.

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